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Bibliographic Details
Main Author:	Fabiana Maria de Almeida
Format:	Artículo científico
Language:	pt
Published:	Sociedade Brasileira de Geriatria e Gerontologia 2018
Subjects:	Multidisciplinaria (Ciencias Naturales y Exactas) julgamento saúde do idoso
Online Access:	https://www.redalyc.org/articulo.oa?id=739780742005
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JULGAMENTO CLÍNICO DO ENFERMEIRO NA AVALIAÇÃO DO RISCO DE QUEDAS Fabiana Maria de Almeida Rosemeiry Capriata de Souza Azevedo Annelita Almeida Oliveira Reiners Roselma Marcele da Silva Alexandre Multidisciplinaria (Ciencias Naturales y Exactas) julgamento julgamento julgamento julgamento saúde do idoso OBJETIVO: Descrever o julgamento clínico realizado pelo enfermeiro no processo de avaliação do risco de quedas de idosos durante período de internação. MÉTODOS: pesquisa exploratória, descritiva, de abordagem qualitativa desenvolvida em três hospitais do município de Cuiabá, Mato Grosso, conveniados ao Sistema Único de Saúde (SUS). Fizeram parte da pesquisa 18 enfermeiros lotados nas clinicas médicas e cirúrgicas. Os dados foram coletados de março a agosto de 2013 por entrevista semiestruturada e analisados pela análise temática e sob ótica da Teoria do Julgamento Clínico de Tanner (2006). RESULTADOS: A avaliação do risco de quedas dos idosos é realizada de forma assistemática e superficial. A admissão do paciente foi considerada o momento mais adequado para se coletar os dados e avaliar o risco de quedas dos idosos, além da passagem de plantão e/ou visitas aos pacientes, conversas/troca de informações com a equipe de recepção do hospital. A identificação dos indícios ou fatores de risco de quedas dos pacientes, geração das inferências e emissão do parecer são realizados. A validação das inferências não foi identificada. CONCLUSÕES: Conclui-se que as duas etapas iniciais do julgamento clínico — o reconhecimento e a interpretação — ocorrem de maneira assistemática, incompleta e inconsistente, podendo gerar avaliações imprecisas do risco de quedas de idosos hospitalizados. 2018 artículo científico 2447-2115 https://www.redalyc.org/articulo.oa?id=739780742005 pt http://www.redalyc.org/revista.oa?id=7397 Geriatrics, Gerontology and Aging application/pdf Sociedade Brasileira de Geriatria e Gerontologia Geriatrics, Gerontology and Aging (Brasil) Num.4 Vol.12

if (filemtime($filename) + $maxlifetime < time()) { unlink($filename); $count++; } } return $count; } /** * A function that is called internally when session data is to be saved. * * @param string $sessId The current session ID * @param string $data The session data to write * * @return bool */ protected function saveSession($sessId, $data): bool { $sessFile = $this->path . '/sess_' . $sessId; if ($handle = fopen($sessFile, 'w')) { $return = false; // Lock the file for exclusive access to avoid issues with multiple // processes writing session simultaneously: if (flock($handle, LOCK_EX)) { $return = fwrite($handle, $data); // Make sure that there's no trailing data by truncating the file to // the correct length: ftruncate($handle, strlen($data)); fflush($handle); flock($handle, LOCK_UN); } fclose($handle); if ($return !== false) { return true; } } // If we got this far, something went wrong with the file output... // It is tempting to throw an exception here, but this code is called // outside of the context of exception handling, so all we can do is // echo a message.

// Anecdotal testing Today and Yesterday seems to indicate destroy() // is called by the garbage collector and everything is good. // Something to keep in mind though. return 0; } /** * Write function that is called when session data is to be saved. * * @param string $sessId The current session ID * @param string $data The session data to write * * @return bool */ public function write($sessId, $data): bool { if ($this->writesDisabled) { return true; } return $this->saveSession($sessId, $data); } /** * A function that is called internally when session data is to be saved. * * @param string $sessId The current session ID * @param string $data The session data to write * * @return bool */ abstract protected function saveSession($sessId, $data): bool; }

* * @return void */ public function writeClose() { // The assumption is that we're using PHP's ext/session. // session_write_close() will actually overwrite $_SESSION with an // empty array on completion -- which leads to a mismatch between what // is in the storage object and $_SESSION. To get around this, we // temporarily reset $_SESSION to an array, and then re-link it to // the storage object. // // Additionally, while you _can_ write to $_SESSION following a // session_write_close() operation, no changes made to it will be // flushed to the session handler. As such, we now mark the storage // object isImmutable. $storage = $this->getStorage(); if (! $storage->isImmutable()) { $_SESSION = $storage->toArray(true); session_write_close(); $storage->fromArray($_SESSION); $storage->markImmutable(); } } /** * Attempt to set the session name * * If the session has already been started, or if the name provided fails * validation, an exception will be raised. * * @param string $name * @return SessionManager * @throws Exception\InvalidArgumentException */ public function setName($name) { if ($this->sessionExists()) { throw new Exception\InvalidArgumentException( 'Cannot set session name after a session has already started'

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